Multiple Organ Dysfunction Syndrome and Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Cerebral Malaria.
Multiple Organ Dysfunction Syndrome and Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Cerebral Malaria.
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DOI：
10.4269/ajtmh.22-0140
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发表时间：
2022-10-12
期刊：
影响因子：
--
通讯作者：
O'Brien N
中科院分区：
文献类型：
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作者：
Johnson H;Raees M;Urbina E;Muszynski J;Seydel K;Taylor T;O'Brien N
据估计，2020年疟疾导致62.7万人死亡，其中大部分是5岁以下儿童。脑型疟疾（CM）是该病的一种严重表现，病死率高达40%。CM患儿的尸检显示恶性疟原虫寄生虫在大脑和其他多个器官中被隔离。因此，多器官功能障碍综合征（MODS）可能存在于儿童CM患者中，但其发生频率及其与死亡率的相关性尚未得到评估。这是一项回顾性研究，前瞻性地收集了马拉维布兰太尔的CM儿童的数据。提取了计算儿科逻辑器官功能障碍-2（PELOD-2）评分所需的体格检查结果和实验室值，PELOD-2评分是一种经验证的方法，可量化危重儿童的器官功能障碍。共纳入145例患者。死亡率为15%（n = 22）。10例患者（7%）有单个器官功能障碍，36例（25%）有两个器官受累，68例（47%）有三个器官功能障碍，31例（21%）患者有四个器官受累。除神经功能障碍外，涉及的其他器官系统包括血液系统（77%）、肾脏（61%）、心血管系统（44%）和呼吸系统（1%）。存活者入院时PELOD-2评分中位数为4分（四分位距[IQR] = 3-6），死亡者为6.5分（IQR = 5-10）（P < 0.0001）。入院PELOD-2评分预测死亡率，曲线下面积为0.75。多器官功能不全综合征在小儿CM患者中广泛存在。客观地识别MODS儿童，因此死亡风险增加，可能允许分配有限的资源。
Malaria resulted in an estimated 627,000 deaths in 2020, the majority of which occurred in children under 5 years of age. Cerebral malaria (CM) is a severe manifestation of the disease with case fatality rates of up to 40%. Autopsies in children with CM have demonstrated sequestration of Plasmodium falciparum parasites in the brain as well as multiple other organs. Thus, multiple organ dysfunction syndrome (MODS) may be present in pediatric patients with CM, but its frequency and association with mortality have not been evaluated. This is a retrospective study of data collected prospectively from children with CM admitted in Blantyre, Malawi. Physical examination findings and laboratory values necessary to calculate a Pediatric Logistic Organ Dysfunction–2 (PELOD-2) score, a validated method that quantifies organ dysfunction in critically ill children, were abstracted. A total of 145 patients were included. Mortality was 15% (n = 22). Ten patients (7%) had single organ dysfunction, 36 (25%) had two organs involved, 68 (47%) had dysfunction of three organs, and 31 (21%) patients had four organs affected. Beyond neurologic dysfunction, other organ systems involved included hematologic (77%), renal (61%), cardiovascular (44%), and respiratory (1%). The median PELOD-2 score on admission was 4 (interquartile range [IQR] = 3–6) in survivors and 6.5 (IQR = 5–10) in the nonsurvivors (P < 0.0001). Admission PELOD-2 score predicted mortality with an area under the curve of 0.75. MODS is widespread in pediatric patients with CM. Objectively identifying children with MODS, and therefore at an increased risk of mortality, may allow for the allocation of limited resources.
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影响因子：
--
作者：
Afolayan FM;Adedoyin OT;Abdulkadir MB;Ibrahim OR;Biliaminu SA;Mokuolu OA;Ojuawo A
通讯作者：
Ojuawo A
影响因子：
15.1
作者：
Conroy, Andrea L.;Hawkes, Michael;Kain, Kevin C.
通讯作者：
Kain, Kevin C.
急性肾脏损伤在小儿严重疟疾中很常见，与死亡率升高有关。
影响因子：
4.2
作者：
Conroy AL;Hawkes M;Elphinstone RE;Morgan C;Hermann L;Barker KR;Namasopo S;Opoka RO;John CC;Liles WC;Kain KC
通讯作者：
Kain KC
影响因子：
2.3
作者：
Batte A;Starr MC;Schwaderer AL;Opoka RO;Namazzi R;Phelps Nishiguchi ES;Ssenkusu JM;John CC;Conroy AL
通讯作者：
Conroy AL
影响因子：
2.3
作者：
Evans, Rhys D. R.;Hemmila, Ulla;Dreyer, Gavin
通讯作者：
Dreyer, Gavin